Document Detail


Improvement of postprandial hyperglycemia has a positive impact on epicardial flow of entire coronary tree in acute coronary syndromes patients.
MedLine Citation:
PMID:  17587714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent studies have shown that a global flow abnormality affects the entire coronary tree in patients with acute coronary syndrome (ACS), and that it is associated with adverse outcomes. Postprandial hyperglycemia is also thought to promote coronary endothelial dysfunction, as well as the release of inflammatory and vasoconstrictive factors. This study used the corrected Thrombolysis In Myocardial Infarction frame count (CTFC) to investigate whether optimal control of postprandial hyperglycemia improves pan-coronary flow. METHODS AND RESULTS: Eighty ACS patients with postprandial hyperglycemia who had successful coronary intervention and who had undergone a 75-g oral glucose tolerance test (OGTT) were included. A second OGTT and angiogram were performed 8 months after procedures. The patients were divided according to postprandial glycemia after the second 75-g OGTT; optimal postprandial hyperglycemia was defined as a 2-h blood glucose concentration <7.8 mmol/L. Changes in the CTFC of culprit/non-culprit arteries, glucose response, and other clinical variables were compared. Forty patients improved to an optimal control at 8 months. In the culprit artery, the 8-month angiogram revealed a significantly improved CTFC among those with optimal control compared with the initial angiogram (30+/-9 vs 24+/-12, p<0.05). In contrast, the CTFC was not evidently improved among patients with suboptimal control. The CTFC at 8 months had thus obviously improved more in patients with optimal, than with suboptimal control (24+/-12 vs 30+/-11, p<0.05). CONCLUSION: Optimal control of postprandial hyperglycemia improves epicardial blood flow in both arteries and this beneficial effect might be from improved coronary endothelial function.
Authors:
Raisuke Iijima; Rintaro Nakajima; Kaoru Sugi; Masato Nakamura
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  71     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1079-85     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Ohashi Hospital, Toho University School of Medicine, Tokyo, Japan. Raisuke329@aol.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina, Unstable / physiopathology*
Blood Circulation / physiology*
Blood Glucose / metabolism
Case-Control Studies
Coronary Vessels / physiopathology
Diet Therapy
Endothelium, Vascular / physiopathology
Female
Glucose Tolerance Test
Humans
Hyperglycemia / physiopathology*,  therapy*
Life Style
Male
Middle Aged
Myocardial Infarction / physiopathology*
Postprandial Period*
Regional Blood Flow / physiology
Weight Loss / physiology
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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